Doctor Name: | MRS. MARLA ANNE SHAMPINE |
NPI Number: | 1346501129 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | R.N. |
License Number: | 318244-1 |
Business Practice Address: | 25 Wilson St Gouverneur, NY - 136421328 |
Business Phone Number: | 3152874300 |
Business Fax Number: | |
Mailing Address: | 25 Wilson St, GOUVERNEUR |
State: | NY |
Postal Code: | 136421328 |
Phone Number: | 3152874300 |
Fax Number: | |
NPI Enumeration Date: | 06/07/2012 |
NPI Last Update Date: | 06/07/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WS0200X |
License Number: | 318244-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | School |
Taxonomy Definition: |